International Patient Care Experience Form
Your experience and feedback are important to us. This form has been designed to help us evaluate the quality of care and services provided to our international patients. You may use it to share your experience, suggestions, concerns or complaints.
About Your Visit
Full Name
*
E-Mail
*
Phone Number
*
Date Of Visit
*
-
Ay
-
Gün
Yıl
Date
Treatment or Service Received
*
Dental Implant
Dental Crown or Veneer
Smile Design
Orthodontic Treatment
Teeth Whitening
General Dental Treatment
Consultation
Other
Appointment and communication process
*
1
2
3
4
5
Clarity of treatment information
*
1
2
3
4
5
Professionalism of the clinical team
*
1
2
3
4
5
Cleanliness and comfort of the clinic
*
1
2
3
4
5
Support provided to international patients
*
1
2
3
4
5
Overall care experience
*
1
2
3
4
5
How likely are you to recommend Teras Dental to a friend, family member or colleague?
*
Not at all likely
1
2
3
4
Extremely likely
5
1 is Not at all likely, 5 is Extremely likely
Please share your comments, suggestions, concerns or complaints.
*
Would you like a member of our Patient Relations Team to contact you regarding your feedback?
*
Yes
No
I confirm that the information provided may be reviewed by Teras Dental for the purpose of responding to my feedback and improving patient care and services.
*
I confirm
Submit
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